Mother's Powerful Tale: Despite My Son's Heroin Addiction, I Held Biases About Drug Addicts
I recognized the number. My son was calling from the ER, barely coherent, having overdosed on heroin yet again. The paramedics had just happened upon him as they were resuscitating another overdose victim in the park. Apparently, the batch of heroin on the street was especially potent and a rash of overdose victims had arrived in the ER that day. My son had suffered an even closer brush with death than I had previously witnessed. This time he had slipped past respiratory arrest and into cardiovascular collapse. If it weren’t for the unfortunate happenstance of another person overdosing in the same park, he surely would have died this time.
When I arrived in the ER, he was still in and out of consciousness. His blood pressure was extremely low and I was concerned that no one was coming to check on him. I was relieved at first when a doctor stepped in.
“Sir, sir!” he shouted as he shook my son’s shoulder. “Are you ready to leave? It’s time for you to go.”
I protested that his blood pressure was only 73/32 and he was barely conscious. How could he possibly be stable enough for discharge?
“Look. We have people with real problems, like chest pain, in the waiting room,” the doctor said as he turned to leave.
“You turn around this instant," I said, enraged. "You will put a human face to this! My son almost died. He deserves the same respect and dignity as anyone else who sets foot in this ER.”
I was appalled that a medical professional could treat another human being in such an inhumane and callous way. That fierce mother-rage was a blessing of sorts, as it held a pivotal moment for me. Even in the midst of my outrage at this physician, I understood his attitude a little too well and this left me with an annoying, nagging sense of guilt. I could no longer avoid the fact that I, too, despite having an addicted son, had some long-held biases against people who use drugs.
Rewind a few years: “Why is he here again? The dope supply on the street must be running dry or maybe it’s because it’s so cold outside tonight,” I thought. “Either which way, he’s just looking for 'three hots and a cot.' It’s his choice to be a junkie and live on the street. He did this to himself. He obviously enjoys living this way or he’d quit shooting up, so why should we have to waste time and resources on him?”
We even had a name for it: malingering, the assumption being that homeless junkies showed up in the emergency room faking symptoms in order to find a place to sleep for the night. My thoughts were racing and I was stressed. It was a busy night in the psychiatric emergency department and our beds were quickly filling up with patients who had real problems such as schizophrenia or bipolar disorder; problems that originated from organic brain disorders these patients did not bring upon themselves, unlike the junkies who enjoyed getting high and were unmotivated to exercise the willpower to simply quit.
I tried to hide my indignation and remain professional as a nurse, yet there’s no doubt that this young man must have sensed the contentiousness in my curt manner toward him as I reserved my compassion and energy for the other, more deserving patients on the unit. My attitude was sadly understandable in some ways. When it comes to issues that have devastating effects, those issues we fear and can’t quite make sense of, our own defense mechanisms tend to kick in. Emotionally, it’s much easier to construct walls of contempt and blame than to face a brand of pain and suffering that we don’t know how to relate to and that we feel helpless to change.
Yet, what did I really know about the experience of drug users? Even though I had encounters with drug users on a daily basis in my work as a nurse, I had only caught a glimpse, a quick snapshot, filtered through a lens of bias and stigma, of what their lives and struggles were actually about.
Fast-forward a few years from that night (and many others like them) in that busy psych ED and know this: I will forever owe amends, just as we collectively do as a society, to every drug user I have treated with such naÃ¯ve, and therefore, callous disregard. What had previously been a biased and stigmatized snapshot evolved into an album, or more precisely a viscerally heart-wrenching library of a drug user’s experience, which began for me the day I learned my 16-year-old son was hooked on heroin.
How could this happen to him? How could this happen in middle-class suburbia? This only happens to other people—out-of-control musicians and movie stars or thugs living on skid row. What did I do wrong? I thought we raised him to know better. Was it because his father and I divorced when he was so young? And so the shame and stigma grows even from the inside looking out. Beyond a treatment center or a 12-step meeting, I was afraid to talk to anyone about my son’s problems. I was afraid of how people would view me. If I stigmatized myself, as the mother of an addict, one can only imagine the ways in which my son must stigmatize himself.
I see him struggle against the horrid things people say to him on the streets, but I also watch him succumb to the jabs as he tells me, “I try not to believe that I’m a piece of shit, but in some ways I guess I am. I guess my whole life is just an example of what not to be.”
He sits, disheveled, in a coffee shop pretending not to notice the sneers, the gawking, the quickly averted glances of other patrons. He finishes a game of Sudoku he found in a discarded newspaper and on his way out the door tosses the paper onto a gawker’s table, as if to say, “I’m human and I’m not the idiot you assume I am.” No one could possible shame my son as much as he shames himself.
Yet, the reality is drugs do not discriminate. Hardcore drugs, heroin in my son’s case, are being bought and sold in suburbia. They are in our schools. They are not just the pastime of rock stars and actors with too much time and money on their hands. They cross all cultural and socioeconomic lines. As a matter of fact, they are cheap. Teenagers are becoming addicted to opiate pain pills, and when they can no longer find or afford pills, heroin offers an affordable solution. We’re surrounded by people either suffering from addiction or concerned for a family member, yet we remain oblivious to it because addiction, especially to hard core and IV drugs, is so shrouded in stigma and shame we refuse to talk about it.
What will it take for us to drop the shame and begin a conversation? Maybe that’s too scary a question to ask. Perhaps we shouldn’t wait for the proverbial shoe to drop, perhaps we shouldn’t wait until deaths from overdose double again in our country. Perhaps the time to have this conversation is now.
As my son’s addiction progressively worsened, there were multiple failed attempts at treatment in private rehabs. Why couldn’t he muster the willpower and stay committed to quitting? It may not have helped that, when he was doing well, private insurance decided not to pay after two weeks, because he had already exhausted the 30 days a year he was allowed for treatment. As I learned over time, this was not a symptom of my son’s moral failing or lack of willpower, but rather of a broken system at the healthcare, insurance and societal levels, a system that views addiction as moral ineptitude rather than the chronic, debilitating disease it actually is. Am I contradicting my earlier views? I most certainly am. As a mother and as a nurse watching my son change into someone I no longer recognized right before my eyes, and being hell-bent on understanding why, a few things became startling clear.
With the evolution of PET scanning and functional MRIs, researchers are now able to validate what they could only speculate on previously. We now know that addiction is not as simple as falling prey to cravings or using drugs to avoid painful withdrawals. It’s much more complex than that. Addiction literally changes the function and even the structure of the brain itself, especially in areas of the brain responsible for motivation, impulsivity and decision making. Simply put, in many ways addiction hijacks parts of the brain; in particular those parts of the brain that control functions we tend to assign a moral value to, such as willpower and motivation. So, in those desperate moments that I’ve cried out “What evil thing has kidnapped my son?” I actually haven’t been too far off the mark.
In general, a mother knows when her child is being disingenuous. When my son says he wants to quit, he means this with every fiber of his being. When he impulsively jumps up to leave before we can obtain treatment, he genuinely apologizes, to himself as much as to me. I’ve literally watched this brain-hijacking in progress. My son is driven by want for wants that he desperately does not want. This peculiar, disturbing wanting can be so pervasive it takes precedence over even the most basic of needs such as food, shelter, clothing and hygiene.
I once picked up my son for lunch (another attempt at getting him into treatment) when he was fairly new to living on the streets. He looked painfully thin and he burst into tears as he greeted me, wanting to hug me, but hesitant to do so, because it had been days since he had found a place to shower.
It’s not my son’s choice to live as he does. He would never freely choose many of the “choices” he has made as he has struggled with his addiction. He does not spend his nights in an alley, the ER or in jail because of a moral failing on his part.
Instead, it is our systems which have failed my son. We live in a social culture, that with very little knowledge or experience, offhandedly views addiction as a moral issue resulting from a lack of willpower. Drug users are viewed as criminals, and so people suffering from debilitating illnesses are shuffled from the street to the ER to jail on a non-stop carnival ferris wheel. Yet we expect people with addictions to face their issues in the midst of all this chaotic instability and stress? Our healthcare system treats addiction in the same moralistic, punitive way, cutting off the already negligible treatment allowances when a patient happens to relapse.
What if we treated other chronic diseases this way? “I’m sorry Ms. Johnson, but your blood sugar reading was high again. You obviously have not been following your diabetic diet. Your insurance company has reviewed this matter and has determined that it will not make any further payments this year for treatment or medication. If you begin making better choices, perhaps you can avoid a gangrenous foot between now and next January. Perhaps by then you will have learned your lesson and will choose to be more complaint with your treatment."
This is as ludicrous as it sounds, and yet it is precisely how the healthcare system behaves toward those who seek treatment for their drug use.
Chances are you know someone who is struggling with a serious addiction or someone concerned about their loved one’s drug use. Chances are, like my son, the young man you encounter on the street panhandling for his next fix, has a concerned family somewhere who has done anything and everything this broken system will allow to try to find effective help for him. Chances are, at the very moment this disheveled young man approaches you and asks for a dollar, he has a loved one somewhere worried sick, hoping he’ll get clean, or at least not overdose tonight. When you meet him, please remember that he has probably tried with all his might to quit just as many times as he has given up all hope.
When my son approaches you on the street, please look him in the eye as a fellow human being and realize that he has been through horrors most of us cannot even imagine and that he blames and kicks himself for this more than anyone else possibly could. When you meet my son, please treat him as you would your best friend’s son, because chances are you have a friend, or a friend of a friend, who has a loved one out there, just like I do.
This article also appeared on Substance.com.